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Introduction

The engagement of patients and their families in patients’ health care is a prominent goal of the EHR Incentive Program (also called Meaningful Use).  As the second of five health policy priorities, this policy priority aims to improve patients’ understanding of their health and related conditions so they take a more active role in their health care.  It also encourages the involvement of patients’ families, as many patients depend on their support.  As a healthcare provider, you will find that the use of certified EHR technologies can assist with making health information available to your patients and their families.  Meaningful use of EHRs will also help you involve patients and their families in healthcare decision making and promote patients’ management of their own health.  

Why is it important to engage patients and families in their healthcare?  Most importantly, it is vital to improving patients’ health outcomes.  Patients who are well informed of their medical condition are more likely to comply with their provider’s recommended regimen.  They are also better able to communicate important health information to their providers, which can assist providers with their diagnosis and care plans.  Informed and educated patients and their families can take an active role in healthcare decision making; for example, when faced with multiple treatment options (e.g., choice of breast or prostate cancer treatments), educational materials and tools can help them share in treatment decisions.  They are also more likely to effectively manage their own care, as healthy behaviors and chronic care are ongoing, everyday activities.  Patients’ participation in chronic care self-management programs can have a substantial impact on their health (e.g., self-management programs for diabetics that help patients effectively manage their diabetes).  

Along with improved health outcomes, active involvement of patients and families can lower underuse or overuse of medical services and reduce health care costs.  For example, when patients seek care from multiple providers, patients who have copies of or access to their medical records (e.g., immunization records) can show these records to the provider and avoid unnecessary or duplicative laboratory tests or procedures.  Providers who use EHRs also benefit through increased practice efficiency and reduced staff workloads.  

Below are the Stage 1 Meaningful Use objectives and measures that address the engagement of patients and families:

Health Policy Priority:  Engage patients and families in their health care

Stage 1 Objectives and measures

Objective

 

Eligible Professional

Eligible Hospital

Measure

Core Set

Provide patients with an electronic copy of their health information (including diagnostic test results, problem list, medication lists, medication allergies), upon request

 

Provide patients with an electronic copy of their health information (including diagnostic test results, problem list, medication lists, medication allergies, discharge summary, procedures), upon request

 

More than 50% of all patients who request an electronic copy of their health information are provided it within 3 business days

 

 

 

Provide patients with an electronic copy of their discharge instructions at time of discharge, upon request

 

More than 50% of all patients who are discharged from an eligible hospital or emergency department and who request an electronic copy of their discharge instructions are provided it at discharge

 

Provide clinical summaries for patients for each office visit

 

 

Clinical summaries provided to patients for more than 50% of all office visits within 3 business days

 

Menu Set

Provide patients with timely electronic access to their health information (including lab results, problem list, medication lists, medication allergies) within four business days of the information being available to the eligible professional

 

 

More than 10% of all unique patients seen by the eligible professional are provided timely (available to the patient within four business days of being updated in the certified EHR technology) electronic access to their health information subject to the eligible professional's discretion to withhold certain information

 

Use certified EHR technology to identify patient-specific education resources and provide those resources to the patient if appropriate

 

Use certified EHR technology to identify patient-specific education resources and provide those resources to the patient if appropriate

 

More than 10% of all unique patients seen by the eligible professional or admitted to the eligible hospital's inpatient or emergency department during the EHR reporting period are provided patient-specific education resources

 

These Meaningful Use objectives will support you in providing patients and families with health information and clinical summaries so that they can manage their care at home and throughout their everyday lives.  This is particularly relevant to patients with chronic conditions (e.g., asthma, cardiovascular disease, diabetes, and heart failure), as these patients play a major role in managing their health.  (Patients with diabetes, for example, provide approximately 95 percent of their own care.)  These objectives also encourage providers to offer patients the information and tools they need to help manage their medical conditions and practice healthy behaviors.   

The patient and family engagement objectives also promote the sharing of patients’ medical information, which is necessary for coordinating care among patients’ multiple providers.  Providing patients with copies of their health information and clinical summaries will allow patients to share this information with their other healthcare providers.  Although their health information will ultimately be shared through EHR technologies, until this is available patients can share this information by handing providers a hard copy or by allowing providers access to their health information via a PHR or patient portal.  Allowing patients easy access to their health records also may also reduce medical errors, as patients can monitor their own health records and report any mistakes.

Your certified EHR technology can support your efforts to provide patients with an electronic copy of their health information, discharge instructions (if appropriate), clinical summaries, and timely electronic access to health information.  In addition, it can identify and provide educational resources that are targeted to specific patients and medical conditions.  These tools provide opportunities for patients to learn about their health condition and enable them to be active team members in their healthcare.

This module poses questions on Meaningful Use and patient and family engagement, then provides a response and suggests additional resources.  Only Stage 1 criteria for demonstrating Meaningful Use are addressed, as Stage 2 and Stage 3 criteria have not yet been finalized by CMS.  The terms ‘EHR Incentive Program’ and ‘Meaningful Use’ are used interchangeably throughout.

Related Resources:

EHR Incentive Program Final Rule – Federal Register announcement of the Centers for Medicare and Medicaid Services’ (CMS) Final Rule for the EHR Incentive Program.  See pages 44353-44360 for detailed information on patient and family engagement objectives and measures.  
ONC Standards and Certification for EHRs – Information on certification criteria and standards that are being used to support Meaningful Use.  This website includes links to the Final Rule, facts-at-a-glance, and frequently asked questions.
Aligning Our Efforts to Transform America's Healthcare go to exit disclaimer– National Quality Forum report that set the stage for the health policy priorities and their associated Meaningful Use objectives and measures.  
The Missing Link: Bridging the Patient-Provider Health Information Gap go to exit disclaimer– Health Affairs article outlining the potential of EHRs to inform patients and make them partners in their healthcare.
Benefits of Patient Involvement go to exit disclaimer– World Health Organization report on the benefits of patient involvement in their medical decision making and factors that support their involvement.  
Meaningful Use of Electronic Health Records go to exit disclaimer– Webcast video of presentations by Dr. Neil Calman and Peter Cucchiara, The Institute for Family Health, with an overview of Meaningful Use and how providers can assess their readiness to participate.

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